by Lauriann Greene, C.E.A.S., and Richard W. Goggins, C.P.E., L.M.P.

Remember to Breathe, MASSAGE MagazineMany massage therapists unconsciously hold their breath or breathe shallowly while they work. The most common cause is tension. It can be emotional tension, due to stress or anxiety, or physical tension due to awkward postures, fatigue or a number of other causes.

Your tissues need oxygen to function properly, so any decrease in breathing is problematic for your musculoskeletal health. It also becomes a vicious circle: you feel stressed or uncomfortable, so you breathe shallowly; the lack of breath causes more tension, which leads to more shallow breathing, and so on. Working with that kind of tension puts you at risk for work-related injury.

Ask a colleague to watch you work and look for signs of reduced breath like raised shoulders and/or stiffness in the way you move. If your colleague points out that you’re not breathing deeply, stop and ask yourself: Do I feel stressed? Am I uncomfortable? Take a moment to adjust your position or your work environment (for example, your table height). Take a deep breath, and as you exhale, think of blowing your stress or discomfort out of the room. As you breathe deeply, your client will likely do the same, which will help her to be more receptive to your treatment.

Get in the habit of doing breathing exercises every day. Try breathing in on a count of five, then out on a count of five while expanding your ribs in all directions (we call this “three-dimensional breathing”). Make sure you’re breathing from the diaphragm, deep in the abdomen. With practice, you can make breathing deeply a reflex that dispels tension as you work.

Reproduced with permission from Save Your Hands! The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists, 2nd Edition, , C.E.A.S., and Richard W. Goggins, C.P.E., L.M.P., © 2008 Gilded Age Press,